Category Archives: challenges

Suicide, yes I said suicide


A subject we all seem to shy away from. And yet I am guessing it has been around for a long time and seems in my observance to be on the increase. Certainly amongst the medical field.

The root word is from latin sui – self and cidiim – killing, not even really a fair description.suicide

What bugs me more is the judgement. The condemnation, never mind of some. I feel that to a large degree is it because we are not connected any more and that the lack of true “support” across the board reigns. It seems we are all islands.

And yet it could be different. We could “support” people at large more and actually “be” there for people at large.

We have become shallower in our dealings with humans. Human to human is a connection we don’t seem to have anymore. And it is sad.

Suicide is a comment on our society and it is sad.

Not long ago I thought it was dentists that had the highest rate of all professions, medical doctors seem to have taken the lead and how very very sad this is. The healing profession seems unable to heal itself and yet is it as simple as that? What lurks beneath the murky surface of this awful predicament that has surfaced. Ego ? Burn-out? The eternal yearning to be the best? Denigration ? Putting people down? Army style? Again and again? Relentless hours? Death witnessed firsthand uncountable times and the expectation that you walk out the room and have a cuppa????

Many things.

Surely we can find the roots, and deal with them? Academia at large are seemingly unaccountable – should that not change?

Lives being lost as we speak – fathers, mothers, sisters, brothers.

Sad, sad. Is there something YOU can do today? Or will you choose to remain silent and impotent.

Advertisements

Comrades – the real joy of south africa


Oh to sit at the half way mark and watch both the beauty of south africa as well as the glory of our people both running and spectating. We are in truth a rainbow nation that deeply cares for each other across colour and culture and language and on comrades this is on display for the whole world to both see and experience. What a spine chilling, tingling and emotional few hours that really filled my tank with pure joy.

I then went and had lunch with my folks and watched some of the live footage on tv. The interview with Bruce Fordyce about Ann Ashworth was so heart rending. They were only expecting/hoping for the last gold medal and on the day she came out guns blazing and surprised even herself. To see his enthusiasm for her race and the joy of what transpired on the day, beautiful.

Our country is amazing and whilst we still have a lot to work through we are actually working through it. We are not pretending there is no elephant in the room. We are tackling daily life in south africa on a daily basis and working for the good of all.

Comrades day is our commitment to that process in action. Proud to be south african. And wow what a lady is our Ann.

 

 

What is a cough and what is a cold?


The definition of a cough : Middle English: of imitative origin; related to Dutch kuchen ‘to cough’ and German keuchen ‘to pant’, Expel air from the lungs with a sudden sharp sound, kuchen : cough, hack, kuch: fit of coughing,.

A cough is a sound we make that has a deeper cause, like a post-nasal drip, a pneumonia or a bronchitis (blockage in the passageways), a problem with the nerve supplying the lining of the lung, asthma, smoking, a lung tumour, gastric reflux etc. So in my humble opinion cough syrup as such is a little bit like using an antibiotic to treat a viral infection. One needs to treat the cause of the cough. Once one gets to the root of the problem and treats that the kuchen will go away.

🙂

What is a cold? A cold usually implies a viral infection of milder intensity that the “flu”. So many people say I have the flu please give me an antibiotic. Well! Antibiotics DO NOT touch viruses for starters and “the flu” is not the common cold or a bacterial infection like a sinusitis or a bronchitis.

Cold viruses :

  • human parainfluenza virus.
  • Human metapneumovirus.
  • coronaviruses adenovirus.
  • human respiratory syncytial virus.
  • enteroviruses.

A virus is a tiny little living thing of genetic material that infects you. It is vastly different to a bacteria.

(yes do not confuse your google search with 27 years of study…)

Cold viruses generally do not kill you.

However the flu viruses of which there are also many amongst them swine flu and the influenza virus CAN kill you. So that is why we have a flu vaccine. It is so that you don’t get one of the virulent viruses that can kill you. Yes you may still get a cold virus or a bacteria (that is not part of the flu vaccine) …but it will NOT KILL you. Get it???

Alles van jou …


Afrikaans poetry is just my best,

Via jou :

Vra my wysheid Ek verwys jou Ignoreer my Ek upstage jou My meningspyling onderskei jou Jy speel saam want ek verlei jou Ek wil vertaal in waterverf dimensies Ek wil verdwaal en nooit weer hoef te wens nie As ek naby is aan jou As ek naby is aan jou Deur die skare soek ek net na jou Jaar na jaar, jy’s al wat ek onthou Al die kitare speel weer net vir jou Serenade, sang en dans vir jou Ek gaan nooit verloor nie Ek gaan nooit wen nie Jou ten volle verstaan Of ken nie Maar ek is useless sonder jou Ek is useless sonder jou Ek lewe klein en uncomplicated Die een fout is so underrated As ek naby is aan jou As ek naby is aan jou In n kroeg of in n kerk As ons slaap of as ons werk Ons is swak maar ons is sterk Ons is vry maar in geveg Sonder liefde het ons niks Sonder liefde is daar niks Sonder liefde is ek niks Sonder liefde Deur die skare soek ek net na jou Jaar na jaar, jy’s al wat ek onthou Al die kitare speel weer net vir jou N serenade, sang en dans vir jou Ooh ooh ooh Net vir jou

 Hard to translate because the words themselves are enriched with a meaning that is really almost untranslatable – certainly with word for word. One needs a whole sentence to try and impart the deep deep meaning.
Just felt I had to share, anyone who has not heard any of our richly talented artists. There is honestly a treasure chest full of delights to delve into.

Gut microbiom and diabetes – of cats, kefir and insulin :)


I have a patient who is a type 1 diabetic and that patient has a cat who is also type 1. Needless to say they are both on insulin. Now if you thought that is it hard to dose a human try dosing a cat or a dog with insulin. It’s so hard and the margin for error is SO big.

These 2 patients have cut their insulin dose by half and halved their hypos by having kefir three times a day.

Then I came across an article in the Journal of Diabetes (South africa) about the gut bugs and diabetes. It mentions how important gut bugs are in terms of metabolic functioning – normal functioning as well as disease. It concludes by saying that “gut microbiota represents an exciting field with novel therapeutic potential”.

I say you have nothing to lose. Give it a try.kefir.jpg

A peace poem


some times frogs boil

some times minds foil

sticks and stones can not hurt nearly as much as words, ever

some times I wish I lived in the land of never never

hearts beat strong

lives live long

and actually sometimes there is even a king kong

world’s collide

sometimes divide

the crashing waves of hurt subside

and peace can become the normal tide

life is a pulse

a heart beat or two

so simple yet so complex

rather not be constantly vexed

peace is a path

chosen

on purpose

our lives a tapestry recorded and finite

choices all ours and have an impact into eternity

weird to think

sometimes a heart sink

and yet a choice

let peace be your choice

 

 

Newer insulins


Are they any better ?

Yes, yes and yes, if I needed insulin I would only be on the newest latest of them. Are they for everyone?

I certainly believe individualisation is the key here. We now have so many tools in the armament of diabetes and to this end they require to be prescribed for the greatest benefit for the individual.

So, when it comes to what we call basal insulin – background insulin. The insulin that controls your sugar before a meal and overnight and in the back ground so to speak (out side of meals). We now have a lot to choose from : protophane, other long acting basals, analogue basals like : glargine, detemir, newer ultra-long acting like degludec.

In terms of the choice it needs to match the needs of the patient.

If a patient wishes to only inject twice a day we have an option for that.

If a patient prefers an insulin pump we have an option for that.

If a patient is wanting ultimate control above all else there are choices for that.

What is critical is aiming for an A1c of 7 with very little variability. I am always happy to sacrifice A1c for less variability and my most important criteria is no hypos! or as few as possible. They are “Kak” for both brain and patient.